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The federal government has announced it will halve the number of Medicare-funded psychology sessions available to Australians, cutting the temporary additional 10 sessions offered during the pandemic. 

The decision, announced by Health Minister Mark Butler yesterday, is based on an independent evaluation of the Better Access initiative. But the report makes no mention of cutting the extra sessions, due to expire on December 31. Instead it found they “should continue to be made available and should be targeted towards those with more complex mental health needs”. 

The report also found people on the lowest incomes were least likely to access services and had to wait on average 17 days for a session — five days more than those in the highest income quintile. Two in three people also had to pay a gap fee. 

Butler argued that cutting the additional sessions would help address inequitable access — without specifying how — and said the government would instead focus on other recommendations by strengthening the Medicare Benefits Schedule (MBS) to facilitate family and carer involvement in treatment and by funding mental health case conferencing. 

Better Access treatment services cost $827 million in 2021, equating to $618 a person treated and $31 per capita, the report found. During 2019-20, $11 billion was spent on mental health-related services. The national study of mental health and well-being found in 2020-21 that two in five Australians had experienced a mental disorder at some time, and one in five developed a mental disorder that lasted for at least 12 months.

Investing in preventive mental health has a considerable return on investment. One 2018 study by KPMG and Mental Health Australia estimated preventive or early intervention for 50,000 children or young people who had started to develop anxiety or depression would deliver $200 million in long-term benefits — a return on investment of $7.90 for every $1 spent.

It found cognitive behavioural therapy for children whose parents have a depressive disorder or for those experiencing symptoms of a depressive disorder are highly effective at preventing symptoms. 

A report from the Mental Health Commission, also released in 2018, found face-to-face psychological workplace interventions for depression prevention could save $45.8 million across 11 years, and similar interventions to prevent post-natal depression could save $23.3 million across five years. 

University of Melbourne professor emeritus at the school of population and health Anthony Jorm said Australia’s mental health support system was a balancing act between the number of sessions people needed to get benefits and the number of people who could access those sessions.

“If you look at expert consensus and clinical practice guidelines, it’s more sessions rather than fewer to get optimal results,” he said.

But finding a psychologist can be tough. Australia is meeting just 35% of its psychology workforce target, which is the largest shortfall of any mental health profession, according to the Australian Psychological Society.

Jorm said Australia needed to treat mental health more holistically, arguing mental health care should be better incorporated into the government’s “well-being budget”, with a separate budget analysis document assessing how policies affected people’s mental health, ranging from income to secure housing.

“We need to be measuring mental health regularly and relating all government policies to that because everything across the whole government potentially has an implication for mental health problems,” he said.

“We have a very one-sided approach in Australia to mental health. We put our eggs overwhelmingly in the treatment basket and very little in prevention when we need both.”

Should the federal government reverse this decision? Let us know by writing to letters@crikey.com.au. Please include your full name to be considered for publication. We reserve the right to edit for length and clarity.